New Mexico Medical Professional Liability Insurance Market Summary

Doctors in New Mexico have several good options for medical liability insurance. The best insurers in the state are:

  • The Doctors Company

  • The Medical Protective Company

  • Coverys Group

  • MMIC Group

These companies have proven to provide robust financial and legal support for doctors, and all have an A-rating from A.M. Best.

These carriers use proprietary methodologies to set rates and there is no set standard rate across insurers for each specialty. However, New Mexico physicians tend to buy policies with $200,000 a claim/600,000 aggregate per year in coverage, which is the minimum required to qualify for New Mexico’s state liability reforms. New Mexico is unique in that standard insurance carriers only offer occurrence medical malpractice policies. Currently, the medical malpractice insurance market in New Mexico is moderate and stable.

Medical Malpractice Insurance Requirements for New Mexico in 2021

Medical professionals in New Mexico are not required to obtain malpractice insurance. However, hospitals and other healthcare facilities may mandate that physicians carry medical malpractice insurance while working in their facility, and minimum coverage is necessary to enroll as a Patient Compensation Fund (PCF) provider. The average physician requirement for coverage is $200,000 per claim, $600,000 per year in 2021.

Effective January 1, 2022, the required limits of professional liability for PCF-enrolled providers increases from $200,000 to $250,000, and the damage cap for claims against PCF-enrolled providers who are not hospital/outpatient facility employees increases to $750,000, which will be adjusted annually based on the consumer price index.

Malpractice insurance policies for New Mexico doctors will be issued exclusively on a calendar year basis going forward, with policy effective dates of January 1 each year. The PCF has stopped accepting enrollments of policies or policy changes that extend into 2022 and has mandated that, effective January 1, 2022, policies must be issued with the higher underlying limits.

Insurance carriers in New Mexico will be cancelling medical malpractice policies effective January 1, 2022 and physicians will receive a pro-rata refund of premium and surcharge for their shortened 2021 policy. Policies will then renew effective January 1, 2022 with $250,000 limits.

Good doctors need to protect against the possibility of a medical malpractice lawsuit, and working with an independent broker to secure comprehensive medical malpractice insurance is fundamental to reducing risk in your practice.

Medical Malpractice Insurance and COVID-19 in New Mexico

The state confirmed its first positive cases of COVID-19 in the state on March 11, 2020. During the last quarter of 2020, COVID-19 hospitalizations in New Mexico increased, reaching a peak of 947 hospitalizations in December. Cases first spiked in cities with the highest populations, then The most populous counties in the state have seen the largest number of infections, then more rural counties with large Native American populations started to see increases in infection rates.

New Mexico has been hit hard by the COVID-19 pandemic, due in part to a low vaccination rate across the state. In an effort to decrease the spread of the Delta variant, New Mexico restarted a vaccination incentive program in July 2021 offering $100 to residents who get vaccinated. According to the health department, the program resulted in a 333% increase in single shot vaccinations and a 26% increase in completed vaccinations.

With the symptoms of COVID-19 varying from patient to patient, the risk of misdiagnosis is high. To be able to respond confidently to the changing needs of patients in New Mexico during the COVID-19 pandemic, doctors can ease their worries with a comprehensive malpractice insurance policy in place from a top-rated medical malpractice insurance carrier.

Telemedicine in New Mexico

New Mexico has The New Mexico Telehealth Alliance, which is a non-profit corporation dedicated to promoting telehealth solutions that deliver quality healthcare throughout the state, and is made up of public and private health care organizations. New Mexico also enacted their telemedicine parity law in 2013, well before many other states. This means private payers in New Mexico are required to reimburse physicians for telemedicine services in the same way as in-person medical services.

New Mexico covers one of the widest ranges of telemedicine health services in the nation, including:

  • behavioral health

  • addiction/substance misuse treatment

  • counseling & social work

  • home rehabilitation

  • school-based services

  • dental care

  • hospice

In addition, New Mexico’s telehealth policies and procedures state:

  • There is no requirement on where the patient needs to be located at the time of service

  • Physicians can establish a patient-physician relationship through a live video exam before prescribing medications

  • New Mexico Medicaid doesn’t place any restrictions on which providers can bill for telemedicine

It’s clear that telehealth and telemedicine are no longer an innovative approach to healthcare – they are a necessary component, especially for New Mexico’s rural residents. Since physicians are held to the same standard of care regardless of whether they are practicing via telehealth or in-person visits, it is recommended that doctors carry insurance that specifically covers telemedicine.

Malpractice Insurance Rates for New Mexico Doctors

Doctors in New Mexico pay less for medical malpractice insurance policies when compared to most states across the country. See below for approximate rates across all territories for limits of $200,000 Each Claim/$600,000 Aggregate (the most common limits of liability in New Mexico).

Specialty  Approximate Rate
Anesthesiology $11,000
Cardiovascular Disease Minor Surgery $12,000
Emergency Medicine $21,000
Family Practice No Surgery $11,000
General Practice No Surgery $9,000
General Surgery $29,000
Internal Medicine No Surgery $10,000
Obstetrics and Gynecology Major Surgery $40,000
Occupational Medicine $6,000
Ophthalmology No Surgery $7,000
Orthopedic Surgery No Spine $22,000
Pathology No Surgery $8,000
Pediatrics No Surgery $9,000
Psychiatry $7,000
Radiology – Diagnostic $12,000

Tort Reform in New Mexico

The 1970s saw an enormous increase in the cost of medical malpractice insurance across the country, due in part to a sudden increase in suits filed and judgments rendered and the prevalence of occurrence policies rather than claims-made policies. These two factors combined to skyrocket malpractice insurance premiums, causing many states to enact tort reform legislation.

In New Mexico, the state passed the New Mexico Medical Malpractice Act in 1976. This act:

  • established a statute of limitations

  • established a medical review commission

  • limited the payout amount of recoverable damages to $500,000 total

  • worked with the New Mexico Professional Liability Fund Act of 1976 to establish a patient compensation fund

Since that time, the limit of recoverable damages has increased to $600,000 and will continue to increase in the subsequent years. In 2022, damages will be limited to $750,000. In 2011, there was an attempt to raise the cap on damages from $600,000 to $1 million, but the New Mexico Governor vetoed the bill. Tort reform is expected to continue to be an ongoing issue in the state of New Mexico.

New Mexico’s Damage Caps on Medical Malpractice Lawsuits

New Mexico is one of seven states with a Patient Compensation Fund, which limits the amount of damages that may be awarded against an enrolled healthcare provider. Created through the Professional Liability Fund Act of 1976, the PCF provides medical malpractice coverage in excess of the minimum primary insurance requirements of the applicable state.

While many have challenged the constitutionality of damage caps, on March 15, 2021 the New Mexico Supreme Court reversed a trial court’s decision and ruled that the current $600,000 cap on medical malpractice damages for PCF-enrolled providers is constitutional. Then, on April 1, 2021 House Bill 75 was signed into law, which mandates that effective January 1, 2022, the damage cap for claims against PCF-enrolled providers will increase from $600,000 to $750,000. This cap will be adjusted annually based on the consumer price index.

Statute of Limitations for Medical Malpractice Claims

The major guidelines regarding the New Mexico’s medical malpractice statute of limitations are as follows:

  • An individual in New Mexico is required to file a medical malpractice claim within three years from the date of injury

  • In some states, if the injury is not discovered within the three-year deadline then the deadline is extended, but New Mexico does not have this law

  • When a child under the age of six is a victim of medical malpractice, they have until the age of nine to file a medical malpractice lawsuit

Tail Insurance in New Mexico

Most physicians in the state have occurrence malpractice policies, however, doctors practicing in New Mexico that have a claims-made policy and DON’T have Prior Acts insurance (also known as Nose Coverage) need a tail insurance policy to ensure that they’re protected from malpractice claims when changing jobs. Your exposure period begins with your retroactive date (the first date of employment with your last employer) and ends on the policy cancellation date (your last day seeing patients at that job). If a claim is made after your policy expires, tail malpractice insurance will protect you. Often before you begin a new job, your new employer will want to confirm you have tail coverage from your prior job. To get the best rates on tail insurance in New Mexico, contact a broker before you notify your employer of your resignation.

When and why is tail insurance necessary?

When a physician ends their employment, their insurance coverage with that employer also ends. Because most liability policies are underwritten on a claims-made basis, if a claim is filed against you after you leave your employer and your insurance coverage has already ended, you can be exposed to a lawsuit. Tail insurance covers you from your retroactive date up to the last day the policy is in effect – with the ability to report claims years after the last day. Read more about options for tail insurance.

Medical Malpractice Insurance Outcomes in New Mexico for 2020

The total medical malpractice payout in New Mexico for 2020 was $24,698,250.
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Closing Remarks

New Mexico has the highest percentage of doctors in the nation older than 60, which will become more of an issue as the population ages and physicians retire. Despite the fact that New Mexico’s health care industry is hiring more workers, there are also chronic shortages of medical professionals in rural parts of the state, making getting a job in healthcare in rural New Mexico relatively easy. However, many medical students are finding it difficult to repay their medical school loans by practicing in rural communities.

In 2020, only six of New Mexico’s 33 counties were at or above the national benchmark of 8.3 primary care physicians per 10,000 people. To grow the primary care physician workforce, the state enacted the Graduate Medical Education Expansion Program to create and expand primary care physician residency programs, which has already produced promising results.

MEDPLI helps doctors from all specialties. Whether you are a plastic surgeon in Albuquerque, a radiologist in Las Cruces, or a urologist in Rio Rancho, we can help you find medical malpractice insurance. To get coverage from an A-rated carrier, contact us by requesting a quote.